On both the provider and payer side, healthcare professionals "both want to reach patients outside the clinical setting," said Haider. "We have a very strong belief that we can improve the quality of healthcare and manage costs with digital health intervention."

The challenge, he said, is that "there's no easy way to collect data and to intervene: to say, 'Your heart rate is too high for the last couple days, we need to make sure you're doing OK.' There's no simple way to do it."

The usual strategy is for nurses make phone calls to check in on patients, of course. In more demanding cases, staff from home health agencies visit the patient in person. "It's expensive and inefficient," said Haider.

Customized apps can help "tell patients what they need to know at the right time," he said. There's been a lot of momentum on that front in recent years, whether it's Apple's CareKit, Google Fit, Samsung Gear or Qualcomm's work optimizing the cloud for for medical grade sensors, said Haider.

"Hundreds of companies are building sensors for data collection. But how do doctors and payers make these apps? For most apps, it's going to cost $500,000 to $700,000 and take 10 to 12 software developers over many months.

"If I have a clinic of 5,000 patients, it's just not feasible for me to spend that money to make an app," he added. "I just won't recoup the basic cost."

Add to that the fact that "every hospital has different care plans. The clinics have slightly different care plans," said Haider. "And the population, with multiple co-morbidities or different treatment requirements need different apps. There's a huge need for personalization and customization."

Hospitals or physician practices create an account on the Doctella website and can and design their own personalized and branded care programs using hundreds of preloaded clinical templates, across an array of specialties, which were developed by clinicians at Johns Hopkins and elsewhere, said Haider. They can also hire Doctella digital health experts to help them build the apps.

Providers can invited patients to see their specific care programs via email, SMS or through their electronic health record.
And using the company's integrated analytics dashboard, clinicians and staff can track patients' progress with the care plans via the patient's own feedback or mobile device sensors. Doctella makes it easy for physicians to to track reported outcomes, vital signs, exercise routines, medication adherence and more.

Doctella's care programs have their roots in the checklists first developed by Provenost and colleagues at Johns Hopkins.
"Over a decade ago, my colleagues and I at John Hopkins created a simple checklist that defined actionable tasks for doctors and nurses that decreased the rate of deadly infections in the United States and led to the adoption of checklists as a standard of care," said Pronovost in a statement. "Doctella employs the implementation science that is behind checklists, and has worked with patients, caregivers, doctors and nurses, to create CarePrograms, which is easily customizable for providers and patients."
Several physicians – dermatologists, otolaryngologists, surgeons – have already used Doctella to develop their own customized care programs.

"Currently, verbal or paper instructions, a quick call from the doctor or a brief visit are considered state of the art methods for managing patients, outside a hospital or after they leave a clinic," said Adil Haider in a statement. "It is estimated that providers and health plans are wasting over $2.5B on these antiquated modes of partnering with patients. They desperately need a simple, low- cost way to create modern digital health interventions. These interventions can guide patients and families outside of the hospital, follow them, and track outcomes based on device data input and patient reported outcomes."